ArticlePediatric nephrology (Berlin, Germany)2023
Increasing incidence of acute kidney injury in pediatric severe sepsis and related adverse hospital outcomes.
Article in Pediatric nephrology (Berlin, Germany), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Incidence of acute kidney injury-associated mortality in hospitalized children: a systematic review and meta-analysis.BMC nephrology · 2025Pooled it
- Association of Malnutrition with Risk of Acute Kidney Injury: A Systematic Review and Meta-Analysis.International journal of clinical practice · 2023Pooled it
- Development and validation of prediction models for any and severe acute kidney injury in children with sepsis.Pediatric nephrology (Berlin, Germany) · 2026Article
- Low Serum Alkaline Phosphatase Levels in Paediatric sepsis Correlate With Acute Kidney Injury: A Multicenter Retrospective Study.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- Blood transfusion in pediatric sepsis-associated acute kidney injury: a nationwide study of risk factors and outcomes.Pediatric nephrology (Berlin, Germany) · 2026Article
- Pathophysiology and Management of Sepsis-associated Acute Kidney Injury.Clinics in chest medicine · 2026Review
- Pediatric continuous kidney replacement therapy: The Indonesian experience.Pediatric nephrology (Berlin, Germany) · 2025Article
- Epidemiology of participants in a prospective cohort study on pediatric acute kidney injury in South Korea.Childhood kidney diseases · 2025Article
- Unexpectedly high rate of unrecognized acute kidney injury and its trend over the past 14 years.Scientific reports · 2025Article
- Pediatric severe sepsis: epidemiology and risk factors associated with acute kidney injury.Frontiers in pediatrics · 2025Article
- Predicting the prognosis in patients with sepsis by an endoplasmic reticulum stress gene signature.Aging · 2023Article
- Critically ill children with septic shock: time to rediscover renin?Pediatric nephrology (Berlin, Germany) · 2023Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPediatric severe sepsis (PSS) is associated with increased mortality, and acute kidney injury (AKI) is an independent risk factor of mortality in PSS. However, there is little data on impact of AKI on hospital outcomes in PSS.
methodsWe analyzed non-overlapping years of the Kids' Inpatient Database (KID) and National Inpatient Sample (NIS) database between 2003 and 2019 of all pediatric patients with severe sepsis between 1 and 18 years of age. Using ICD diagnosis codes, patients were divided into two groups based on AKI status and compared for outcomes measures including in-hospital mortality and healthcare resource utilization using length of stay and inflation-adjusted hospitalization charges.
resultsWe analyzed 192,712 hospitalizations due to PSS during the 17-year period. Prevalence of AKI was 23.6% with overall increasing trend, P<0.001. Prevalence of AKI was significantly increased in patients with diabetes mellitus, organ transplantation, HIV, urinary tract anomalies, and malnutrition, P<0.001. Mortality rate was significantly higher among patients with AKI (19.8% vs. 8.1%, P<0.001). PSS with AKI had significantly higher median length of stay (14 vs. 11 days) and total hospitalization charges ($168,106 vs. 100,906), P<0.001. Multivariate logistic regression analysis showed that AKI without kidney replacement therapy (KRT) was associated with 3.02 times increased odds of mortality (95% CI 2.99-3.17, P<0.001) and those requiring KRT had 6.4 times increased odds of mortality (95%CI 6.1-6.7, P<0.001). AKI without KRT was associated with 7.7 (95% CI 7.3-8.05) additional days of hospitalization and 154,536 (95% CI 149,500-159,572) additional US dollars in hospitalization charges.
conclusionAlmost 1 in 4 hospitalizations with PSS had AKI and was associated with >3 times increased risk of mortality and need for KRT further adversely impacts mortality and healthcare utilization. A higher resolution version of the Graphical abstract is available as Supplementary information.
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